目的 探讨通心络胶囊联合阿罗洛尔治疗冠心病心绞痛的临床疗效。方法 选取2022年4月—2025年3月在华北医疗健康集团峰峰总医院治疗的冠心病心绞痛患者96例，按随机数字表法分为对照组和治疗组，每组各48例。对照组口服盐酸阿罗洛尔片，10 mg/次，2次/d。治疗组以对照组方案为基础口服通心络胶囊，3粒/次，3次/d。两组患者疗程8周。观察两组患者临床疗效，比较治疗前后两组患者心电图ST-T改善率，心绞痛发作程度、时长和次数，Duke、简式抑郁-焦虑-压力量表（DASS-21）和中国心血管病人生活质量评定问卷（CQQC）评分，及抗凝血酶Ⅲ（AT-Ⅲ）、D-二聚体（D-D）、系统免疫炎症指数（SII）和血清白细胞介素-7（IL-7）和缺血修饰白蛋白（IMA）水平。结果 治疗后，治疗组总有效率为93.75%，明显高于对照组的79.17%，两组比较差异具有统计学意义（P＜0.05）。治疗后，治疗组心电图ST-T改善率（87.50%）显著高于对照组（68.75%，P＜0.05）。两组患者心绞痛程度、时长、次数都低于组内治疗前（P＜0.05），且以治疗组改善更明显（P＜0.05）。治疗后，两组Duke、CQQC评分均高于组内治疗前，而DASS-21评分均下降（P＜0.05），且治疗后治疗组患者评分明显好于对照组（P＜0.05）。治疗后，两组AT-Ⅲ水平都高于组内治疗前，而D-D、SII和血清IL-7、IMA水平均降低（P＜0.05），且治疗组患者上述指标水平明显好于对照组（P＜0.05）。结论 在冠心病心绞痛的治疗中应用通心络胶囊与阿罗洛尔的联合方案，能进一步控制机体的凝血异常，缓解炎症反应及心肌缺血状态，促进患者心绞痛表现和预后好转，对其心理状态和生活质量有积极影响。

Objective To explore the clinical efficacy of Tongxinluo Capsules combined with arotinolol in treatment of angina pectoris in coronary heart disease. Methods Patients (96 cases) with angina pectoris in coronary heart disease in Fengfeng General Hospital, North China Medical and Health Group from April 2022 to March 2025 were divided into control and treatment group according to random number table method, and each group had 48 cases. Patients in the control group were po administered with Arotinolol Hydrochloride Tablets, 10 mg/time, twice daily. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, and the improvement of ECG ST-T, degree, duration and frequency of angina attacks, the scores of Duke, DASS-21 and CQQC, the levels of AT-Ⅲ, D-D, SII, IL-7 and IMA in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 93.75%, which was significantly higher than that in the control group (79.17%), and the difference between the two groups was statistically significant (P < 0.05). After treatment, the improvement rate of ECG ST-T in the treatment group (87.50%) was significantly higher than that in the control group (68.75%, P < 0.05). The severity, duration and frequency of angina pectoris in two groups were lower than before treatment (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, Duke and CQQC scores in two groups were higher than those before treatment, while DASS-21 scores were decreased (P < 0.05). After treatment, the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of AT-Ⅲ in two groups were higher than those before treatment, while the levels of D-D, SII and serum IL-7 and IMA were all reduced (P < 0.05), and the levels of these indicators in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The combination of Tongxinluo Capsules and arotinolol in treatment of angina pectoris in coronary heart disease can further control coagulation abnormalities, alleviate inflammatory reactions and myocardial ischemia, promote the improvement of angina symptoms and prognosis in patients, and have a positive impact on their psychological state and quality of life.

R972

邯郸市科技专项计划自筹经费项目（22422083092）